Financial Support Options

AT GENENTECH, WE ARE DEDICATED TO HELPING ENSURE OUR TREATMENTS ARE ACCESSIBLE FOR PATIENTS

Assistance Options for Your Eligible Patients

Several options are available that may help patients with the out-of-pocket (OOP) costs of SUSVIMO. Find the right patient assistance option for your patient using the Patient Assistance Tool.

Is your patient insured?
Does the patient's insurance cover their Genentech treatment?
Does your patient have commercial insurance?
Has your patient already been referred to the Genentech Ophthalmology Co-pay Program and is either ineligible or no longer receiving assistance?
Has your patient already been referred to an independent co-pay assistance foundation and is either ineligible or no longer receiving assistance?
Is the patient taking SUSVIMO for an FDA-approved indication?

Your Patient Might Qualify for a Referral to the Genentech Ophthalmology Co-pay Program

If eligible commercially insured patients need assistance with their drug and/or administration out-of-pocket costs, the Genentech Ophthalmology Co-pay Program may help.*

Learn More

*Eligibility criteria apply. Not valid for patients using federal or state government programs to pay for their medicine and/or administration of their Genentech medicine. Patients must be taking the Genentech medicine for an FDA-approved indication. Please visit the Co-pay Program website for the full list of Terms and Conditions.

Your Patient Might Qualify for a Referral to an Independent Co-pay Assistance Foundation

For eligible patients with commercial or public health insurance, SUSVIMO Access Solutions offers referrals to independent co-pay assistance foundations.*

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*Independent co-pay assistance foundations have their own rules for eligibility. Genentech has no involvement or influence in independent foundation decision-making or eligibility criteria and does not know if a foundation will be able to help your patient. We can only refer your patient to a foundation that supports their disease state. Genentech does not endorse or show preference for any particular foundation. The foundations to which we refer your patient may not be the only ones that might be able to help.

Your Patient Might Qualify for a Referral to the Genentech Patient Foundation

The Genentech Patient Foundation provides free Genentech treatment to people who don't have health insurance coverage or who have financial concerns and meet eligibility criteria.*

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*To be eligible for free Genentech treatment from the Genentech Patient Foundation, insured patients who have coverage for their treatment should try to pursue other forms of financial assistance, if available, and meet certain income requirements. Uninsured patients and insured patients without coverage for their treatment must meet a different set of income requirements. Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted.

We believe every person should get the SUSVIMO they need, and we offer programs to help make this happen

Genentech Ophthalmology Access Solutions

Genentech Ophthalmology Access Solutions can help your patients and practice by providing:

Benefits investigations (BIs) for drug and device and benefits reverification support
Prior authorization (PA) resources
Information about authorized specialty pharmacies and specialty distributors
Sample billing and coding information
Resources for denials and appeals
Referrals to financial assistance options

Visit Genentech-Access.com or call 833-EYE-GENE (833-393-4363)
Monday-Friday, 9 am-9 pm Eastern Time.

The completion and submission of coverage- or reimbursement-related documentation are the responsibility of the patient and health care provider. Genentech makes no representation or guarantee concerning coverage or reimbursement for any service or item.

Genentech Patient Foundation

If patients don’t have insurance coverage or have financial concerns and meet eligibility criteria, they may be able to get free treatment from the Genentech Patient Foundation.

Eligibility criteria:

Uninsured patients
With incomes under $150,000

Insured patients without coverage for a Genentech medicine
With incomes under $150,000

Insured patient with coverage for a Genentech medicine

With unaffordable out-of-pockets costs
With household size and income within certain guidelines, available at GenentechPatientFoundation.com

How to apply:
1)    Complete the Prescriber Foundation Form
2)    Have your patients complete the Patient Consent Form
3)    Fax both forms to (833) 999-4363

For more information, visit GenentechPatientFoundation.com or call a Foundation Specialist at (888) 941-3331.

For all patient types, add $25,000 for each extra person in households larger than 4 people. We encourage insured patients to try other financial assistance options prior to applying for help from the Genentech Patient Foundation, if possible. Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted.

Genentech Ophthalmology Co-Pay Program

Eligible commercially insured patients pay as little as:
- $0 per drug co-pay,* up to $15,000 per calendar year
- $0 per surgical procedure and refill co-pays,* up to $1,000 per calendar year

To have your patients enroll or learn more, visit EyeOnCopay.com or call (855) 218-5307.

*The Product and Administration Co-pay Programs are valid ONLY for patients with commercial (private or non-governmental) insurance who have a valid prescription for a Food and Drug Administration (FDA)-approved indication of a Genentech medicine. Patients using Medicare, Medicaid or any other federal or state government program (collectively, “Government Programs”) to pay for their Genentech medicine and/or administration services are not eligible.

Under the Programs, the patient may pay a co-pay for drug costs and a co-pay for administration costs. The final amount owed by a patient may be as little as $0 for the Genentech medicine or administration of the Genentech medicine (see Program specific details). The total patient out-of-pocket cost is dependent on the patient’s health insurance plan. The Programs assist with the cost of the Genentech medicine and the Genentech medicine administration only. It does not assist with the cost of other administrations, medicines, procedures or office visit fees. After reaching the maximum Programs’ benefit amounts, the patient will be responsible for all remaining out-of-pocket expenses. The amount of the Programs’ benefits cannot exceed the patient’s out-of-pocket expenses for the cost of the Genentech medicine or administration fees associated with the Genentech medicine.

All participants are responsible for reporting the receipt of all Programs’ benefits as required by any insurer or by law. The Programs are only valid in the United States and U.S. Territories and are void where prohibited by law. The Drug Co-pay Program shall follow state restrictions in relation to AB-rated generic equivalents (e.g., MA, CA) where applicable. The Administration Co-pay Program is not valid for Massachusetts or Rhode Island residents. No party may seek reimbursement for all or any part of the benefit received through the Programs. The Programs are intended for the patient. Only the patient using the Programs may receive the funds made available through the Programs. The Programs are not intended for third parties who reduce the amount available to the patient or take a portion for their own purposes. Patients with health plans that redirect Genentech Program assistance intended for patient out-of-pocket costs may be subject to alternate Program benefit structures. Genentech reserves the right to rescind, revoke or amend the Programs without notice at any time.

Additional terms and conditions apply. Please visit the co-pay Program website for the full list of Terms and Conditions.

See Practice Resources

Talk to a Genentech Representative

Indication

SUSVIMO (ranibizumab injection) is indicated for the treatment of patients with neovascular (wet) age-related macular degeneration (AMD) who have previously responded to at least 2 intravitreal injections of a vascular endothelial growth factor (VEGF) inhibitor medication.

WARNING: ENDOPHTHALMITIS

The SUSVIMO implant has been associated with a 3-fold higher rate of endophthalmitis than monthly intravitreal injections of ranibizumab. Many of these events were associated with conjunctival retractions or erosions. Appropriate conjunctiva management and early detection with surgical repair of conjunctival retractions or erosions may reduce the risk of endophthalmitis. In clinical trials, 2.0% of patients receiving a ranibizumab implant experienced at least 1 episode of endophthalmitis.

Contraindications

SUSVIMO is contraindicated in patients with ocular or periocular infections, active intraocular inflammation, or hypersensitivity to ranibizumab products or any of the excipients in SUSVIMO.

Warnings and Precautions

The SUSVIMO implant and/or implant-related procedures have been associated with endophthalmitis, rhegmatogenous retinal detachment, implant dislocation, septum dislodgement, vitreous hemorrhage, conjunctival erosion, conjunctival retraction, and conjunctival blebs. Patients should be instructed to report any signs or symptoms that could be associated with these events without delay. In some cases, these events can present asymptomatically. The implant and the tissue overlying the implant flange should be monitored routinely following the implant insertion and refill-exchange procedures to permit early medical or surgical intervention as necessary. Special precautions need to be taken when handling SUSVIMO components.

Endophthalmitis

In the active comparator period of controlled clinical trials, the ranibizumab implant has been associated with a 3-fold higher rate of endophthalmitis than monthly intravitreal injections of ranibizumab (1.7% in the SUSVIMO arm vs 0.5% in the intravitreal arm). When including extension phases of clinical trials, 2.0% (11/555) of patients receiving the ranibizumab implant experienced an episode of endophthalmitis. Reports occurred between day 5 and day 853, with a median of day 173. Many, but not all, of the cases of endophthalmitis reported a preceding or concurrent conjunctival retraction or erosion event.

Endophthalmitis should be treated promptly in an effort to reduce the risk of vision loss and maximize recovery. The SUSVIMO dose (refill-exchange) should be delayed until resolution of endophthalmitis.

Patients should not have an active or suspected ocular or periocular infection or severe systemic infection at the time of any SUSVIMO implant or refill procedure. Appropriate intraoperative handling followed by secure closure of the conjunctiva and Tenon’s capsule, and early detection and surgical repair of conjunctival erosions or retractions may reduce the risk of endophthalmitis.

Rhegmatogenous Retinal Detachment

Rhegmatogenous retinal detachments have occurred in clinical trials of SUSVIMO and may result in vision loss. Rhegmatogenous retinal detachments should be promptly treated with an intervention (e.g., pneumatic retinopexy, vitrectomy, or laser photocoagulation). The SUSVIMO dose (refill-exchange) should be delayed in the presence of a retinal detachment or retinal break.

Careful evaluation of the retinal periphery is recommended to be performed, and any suspected areas of abnormal vitreo-retinal adhesion or retinal breaks should be treated before inserting the implant in the eye.

Implant Dislocation

In clinical trials, the device dislocated/subluxated into the vitreous cavity or extended outside the vitreous cavity into or beyond the subconjunctival space. Device dislocation requires urgent surgical intervention. Strict adherence to the scleral incision length and appropriate targeting of the pars plana during laser ablation may reduce the risk of implant dislocation.

Septum Dislodgement

In clinical trials, a type of implant damage where the septum has dislodged into the implant body has been reported. Perform a dilated slit lamp exam and/or dilated indirect ophthalmoscopy to inspect the implant in the vitreous cavity through the pupil prior to and after the refill-exchange procedure to identify if septum dislodgement has occurred. Discontinue treatment with SUSVIMO following septum dislodgement and consider implant removal should the benefit of the removal procedure outweigh the risk.

Appropriate handling and insertion of the refill needle into the septum (avoid twisting and/or rotation) is required to minimize the risk of septum dislodgement.

Vitreous Hemorrhage

Vitreous hemorrhages may result in temporary vision loss. Vitrectomy may be needed in the case of a nonclearing vitreous hemorrhage.

In clinical trials of SUSVIMO, including extension phases, vitreous hemorrhages were reported in 5.2% (23/443) of patients receiving SUSVIMO. The majority of these hemorrhages occurred within the first postoperative month following surgical implantation, and the majority of vitreous hemorrhages resolved spontaneously. Patients on antithrombotic medication (e.g., oral anticoagulants, aspirin, nonsteroidal anti-inflammatory drugs) may be at increased risk of vitreous hemorrhage. Antithrombotic medications are recommended to be temporarily interrupted prior to the implant insertion procedure. The SUSVIMO dose (refill-exchange) should be delayed in the event of sight-threatening vitreous hemorrhage. The use of pars plana laser ablation and scleral cauterization should be performed to reduce the risk of vitreous hemorrhage.

Conjunctival Erosion or Retraction

A conjunctival erosion is a full-thickness degradation or breakdown of the conjunctiva in the area of the implant flange. A conjunctival retraction is a recession or opening of the limbal and/or radial peritomy. Conjunctival erosions or retractions have been associated with an increased risk of endophthalmitis, especially if the implant becomes exposed. Surgical intervention (e.g., conjunctival/Tenon’s capsule repair) is recommended to be performed in cases of conjunctival erosion or retraction with or without exposure of the implant flange.

In clinical trials of SUSVIMO, including extension phases, 3.6% (16/443) of patients receiving SUSVIMO reported conjunctival erosion and 1.6% (7/443) of patients receiving SUSVIMO reported conjunctival retraction in the study eye.

Appropriate intraoperative handling of the conjunctiva and Tenon’s capsule to preserve tissue integrity and secure closure of peritomy while ensuring placement of sutures away from implant edge may reduce the risk of conjunctival erosion or retraction. The implant and the tissue overlying the implant flange should be monitored routinely following the implant insertion.

Conjunctival Bleb

A conjunctival bleb is an encapsulated elevation of the conjunctiva above the implant flange, which may be secondary to subconjunctival thickening or fluid. Conjunctival blebs may require surgical management to avoid further complications, especially if the implant septum is no longer identifiable due to the conjunctival bleb.

In clinical trials of SUSVIMO, including extension phases, 5.9% (26/443) of patients receiving SUSVIMO reported conjunctival bleb/conjunctival filtering bleb leak in the study eye. Strict adherence to the scleral incision length, appropriate intraoperative handling of the conjunctiva and Tenon’s capsule to preserve tissue integrity and secure closure of peritomy, and proper seating of the refill needle during refill-exchange procedures may reduce the risk of conjunctival bleb.

Postoperative Decrease in Visual Acuity

Visual acuity was decreased by an average of 4 letters in the first postoperative month and an average of 2 letters in the second postoperative month following initial implantation of SUSVIMO.

Air Bubbles Causing Improper Filling of the Implant

Minimize air bubbles within the implant reservoir, as they may cause slower drug release. During the initial fill procedure, if an air bubble is present, it must be no larger than ⅓ of the widest diameter of the implant. If excess air is observed after initial fill, do not use the implant. During the refill-exchange procedure, if excess air is present in the syringe and needle, do not use the syringe and needle. If excess air bubbles are observed after the refill-exchange procedure, consider repeating the refill-exchange procedure.

Deflection of the Implant

Use caution when performing ophthalmic procedures that may cause deflection of the implant and subsequent injury. For example, B-scan ophthalmic ultrasound, scleral depression, or gonioscopy.

Adverse Reactions

In the nAMD Archway study following the SUSVIMO initial fill and implant insertion, refill, and implant removal (if necessary) procedures up to week 40, the most common (≥10%) adverse reactions up to week 40 were conjunctival hemorrhage (72%), conjunctival hyperemia (26%), iritis (23%), and eye pain (10%).

Females and Males of Reproductive Potential

Females of reproductive potential should use effective contraception during treatment with SUSVIMO and for at least 12 months after the last dose of SUSVIMO. No studies on the effects of ranibizumab on fertility have been conducted and it is not known whether ranibizumab can affect reproduction capacity. Based on the anti-VEGF mechanism of action for ranibizumab, treatment with SUSVIMO may pose a risk to reproductive capacity.

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.

Please see additional Important Safety Information in the full SUSVIMO Prescribing Information, including BOXED WARNING.

- SUSVIMO [package insert]. South San Francisco, CA: Genentech, Inc; 2022.
  
  SUSVIMO [package insert]. South San Francisco, CA: Genentech, Inc; 2022.
- Campochiaro PA, Marcus DM, Awh CC, et al. The port delivery system with ranibizumab for neovascular age-related macular degeneration. Ophthalmology. 2019;126:1141-1154.
  
  Campochiaro PA, Marcus DM, Awh CC, et al. The port delivery system with ranibizumab for neovascular age-related macular degeneration. Ophthalmology. 2019;126:1141-1154.
- SUSVIMO Initial Fill and Implant Procedure Instructions for Use. Genentech, Inc. 2022.
  
  SUSVIMO Initial Fill and Implant Procedure Instructions for Use. Genentech, Inc. 2022.
- Monés J, Gune S, Maia M, et al. Pharmacokinetic profile of the port delivery system with ranibizumab in the phase 3 Archway trial. Presented at: 21st EURETINA Congress, September 9-12, 2021. Accessed August 25, 2022.
  
  Monés J, Gune S, Maia M, et al. Pharmacokinetic profile of the port delivery system with ranibizumab in the phase 3 Archway trial. Presented at: 21st EURETINA Congress, September 9-12, 2021. Accessed August 25, 2022.
- Ranade SV, Wieland MR, Tam T, et al. The port delivery system with ranibizumab: a new paradigm for long-acting retinal drug delivery. Drug Delivery. 2022;29(1):1326-1334.
  
  Ranade SV, Wieland MR, Tam T, et al. The port delivery system with ranibizumab: a new paradigm for long-acting retinal drug delivery. Drug Delivery. 2022;29(1):1326-1334.
- Data on file. Genentech, Inc. 2021.
  
  Data on file. Genentech, Inc. 2021.
- Data on file. Genentech, Inc. 2021.
  
  Data on file. Genentech, Inc. 2021.
- Holekamp NM, Campochiaro PA, Chang MA, et al; Archway Investigators. Archway randomized phase 3 trial of the port delivery system with ranibizumab for neovascular age-related macular degeneration. Ophthalmology. 2022;129(3):295-307.
  
  Holekamp NM, Campochiaro PA, Chang MA, et al; Archway Investigators. Archway randomized phase 3 trial of the port delivery system with ranibizumab for neovascular age-related macular degeneration. Ophthalmology. 2022;129(3):295-307.
- A phase III study to evaluate the port delivery system with ranibizumab compared with monthly ranibizumab injections in participants with wet age-related macular degeneration. ClinicalTrials.gov identifier: NCT03677934. Updated July 22, 2021. https://clinicaltrials.gov/ct2/show/NCT03677934
  
  A phase III study to evaluate the port delivery system with ranibizumab compared with monthly ranibizumab injections in participants with wet age-related macular degeneration. ClinicalTrials.gov identifier: NCT03677934. Updated July 22, 2021. https://clinicaltrials.gov/ct2/show/NCT03677934
- Wykoff CC; Archway Investigators. 2-year outcomes from the phase 3 Archway trial: management of neovascular age-related macular degeneration using the port delivery system with ranibizumab (PDS). Presented at: Bascom Palmer Eye Institute Angiogenesis, Exudation, and Degeneration 2022 – Virtual Edition, February 11-12, 2022.
  
  Wykoff CC; Archway Investigators. 2-year outcomes from the phase 3 Archway trial: management of neovascular age-related macular degeneration using the port delivery system with ranibizumab (PDS). Presented at: Bascom Palmer Eye Institute Angiogenesis, Exudation, and Degeneration 2022 – Virtual Edition, February 11-12, 2022.
- Chang MA, Kapre A, Kaufman D, et al. Patient preference and treatment satisfaction with a port delivery system for ranibizumab vs intravitreal injections in patients with neovascular age-related macular degeneration: a randomized clinical trial. JAMA Ophthalmology. Published online June 16, 2022. doi:10.1001/jamaophthalmol.2022.1091
  
  Chang MA, Kapre A, Kaufman D, et al. Patient preference and treatment satisfaction with a port delivery system for ranibizumab vs intravitreal injections in patients with neovascular age-related macular degeneration: a randomized clinical trial. JAMA Ophthalmology. Published online June 16, 2022. doi:10.1001/jamaophthalmol.2022.1091